Thyroid No Surgery: Beware of Physicians Ordering Unnecessary Thyroid Ultrasounds and Biopsies.Ultrasound

Thyroid No Surgery: Beware of Physicians Ordering Unnecessary Thyroid Ultrasounds and Biopsies.

Dr.Guttler’s comments:

1. Thyroid ultrasound is not a screening test. It is a test that is used when there are indications.
2.  Family history of thyroid cancer, goiter or Hashimoto’s thyroiditis.
3. Hypothyroidism without a abnormal neck exam is not an indication.
4. Finding a nodule on ultrasound is not an indication for a biopsy.
5. There are criteria for which nodule is at risk for thyroid cancer.
6. Very Low Risk nodules do not need a biopsy. Spongiform nodules and pure cysts.
7. Hypoechoic nodules with no other features are not suspicious also does not need a biopsy.
8. Taller than wide is mildly suspicious and if > than 2.5 cm need a biopsy.
9. Lobulated or irregular margins or extra -thyroidal extension are moderately suspicious and need a biopsy if > 1.5 cm.
10. High risk include marked hypoechoic nodules, taller than wide nodules, and nodules with aggressive margins and some types of calcifications are highly suspicious and need a biopsy if 1.0 cm.
11. Before you have a thyroid ultrasound be sure it is indicated by your history and family history.
12. Thyroid nodules are very common so if you have an indication to have an ultrasound make sure you have a nodule that is not low risk. If you have some risk make sure the size of the nodule matches the risk.
13. Once you have the ultrasound or biopsy  when it was not indicated you are on a slippery slope leading to unnecessary surgery.
14. If you have any doubt about the need for ultrasound or biopsy get an outside opinion first.
15. Contact me at 310-393-8860 or thyroid.manager@thyroid.com.
16. Dr.G.